In terms of tumor characteristics, most elderly patients with liver cancer have slower tumor progression and are easier to control with treatment. However, in terms of the function of the body, the elderly have relatively poor compensatory functions of the heart, lungs, liver, and kidneys, combined with more medical diseases, and sometimes the tumor can be removed but the body cannot tolerate surgery.
Therefore, for the treatment of elderly patients with liver cancer, physicians first consider the patient’s tolerability and only secondly the effectiveness of the treatment. In layman’s terms, it is about keeping the patient alive first, and only secondly about keeping the patient alive long and well, reducing pain and prolonging life. Because of this, for elderly patients with liver cancer, physicians often consider interventional embolization and targeted therapy as the preferred treatment options.
Surgically resectable liver cancer in the elderly
The treatment of early-stage liver cancer is still primarily surgical, and some patients can be cured.
Before elderly liver cancer patients undergo surgical resection, the function of the patient’s heart, lungs, liver, and kidneys should be fully evaluated, and surgical resection should be mainly localized.
Surgically intolerable elderly liver cancer
For elderly liver cancer patients who cannot tolerate surgery, physicians may choose minimally invasive treatments that are less damaging to the organism and organ function, such as microwave ablation, radiofrequency ablation, intratumoral anhydrous ethanol injection, and argon helium knife ablation, which can also achieve the effect of surgery.
For elderly patients with advanced, inoperable hepatocellular carcinoma, treatment is based on interventional embolization, targeted therapy, and chemotherapy.
Considering that elderly liver cancer patients have poor liver function and poor tolerance to the toxic reactions of various antitumor treatments, physicians will focus on liver preservation therapy during treatment to avoid the development of liver failure.
When administering hepatic artery embolization chemotherapy, the physician will reduce the dose of chemotherapy drugs appropriately. If repeat treatment is needed, the interval between treatments will be extended appropriately.
The dose and intensity of antitumor therapy used by physicians in older patients with liver cancer is relatively moderate compared with adult patients to avoid overtreatment for efficacy that could lead to death.
For older patients with liver cancer, physicians will also apply immunomodulators as appropriate or in combination with other adjuvant therapies.